A new study led by researchers at Emory University's Rollins School of Public Health, published Monday by JAMA Network Open , estimates that nearly 20% of U.S. residents who use pre-exposure prophylaxis (PrEP) for HIV prevention—or more than 110,000 of the approximately 580,000 PrEP users nationwide in 2024—received their medication via telemedicine.
This represents a sharp increase from the less than 1% of PrEP users nationwide who received their prescriptions via telemedicine in 2019 and double the 9% who did so in 2022. And it still underestimates the overall telePrEP impact because the study only includes telePrEP data from a single national telehealth provider.
While total PrEP coverage also increased from about 264,000 users in 2019 to more than 591,000 in 2024, the study highlights telehealth's potential to expand HIV prevention access. The Centers for Disease Control and Prevention estimates 2.2 million individuals would benefit from PrEP use, but numerous barriers exist to accessing and staying engaged in PrEP care.
In addition to the increased telePrEP usage, the researchers found:
- Most of the telePrEP users (77%) had not used PrEP previously
- More than one-third (58,761) of telePrEP users were uninsured
- More than 80% of the telePrEP users also opted for at-home testing for HIV and other sexually transmitted infections
"This study indicates that there is a real demand for delivery of services outside of clinics and that the telePrEP model is a promising avenue. As the health care system is undergoing changes, we should keep building on the telePrEP model and continue to innovate in the ways we deliver effective and efficient interventions like PrEP," says study lead author Aaron Siegler, PhD , associate professor of behavioral, social, and health education sciences at Rollins.
The Emory team— in collaboration with researchers from the National Alliance of State and Territorial AIDS Directors , Washington University in St. Louis , and Whitman-Walker Health —used national PrEP prescription data from AIDSVu (an Emory-developed mapping tool) and de-identified HIPAA-compliant data provided by the nation's largest telePrEP provider, MISTR , to conduct what is believed to be the first national assessment of telePrEP provision.
MISTR partners with community-based health organizations that use the federal 340B drug pricing program to subsidize the costs of providing telePrEP free of charge, regardless of an individual's insurance coverage. The for-profit company also covers the cost of labs, consultations, prescriptions, and shipping, which collectively help to remove some of the common cost, stigma, and logistical barriers to HIV prevention.
"This study is validation that our model works and that telehealth can help end HIV and reduce sexually transmitted infections in the U.S.," says Tristan Schukraft, founder and CEO of MISTR. "When care is free, fast, and stigma-free, people use it."
